IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Monday the 19th day of March, 2018
Filed on 02.02.2017
Present
- Smt. Elizabeth George (President)
- Sri. Antony Xavier (Member)
- Smt.Jasmine.D. (Member)
in
C.C.No. 35/2017
between
Complainant:- Opposite Party:-
Smt. Lusy John alias Lucy T.K 1. LIC of India
W/o John K.W Ernakulam Division,
Kackariyil House Divisional Office,
Arthunkal. P.O. Ernakulam.
Cherthala
Alappzuha.
(By Adv.K.S.Hariharaputhran) 2. The Branch Manager
LIC of India,
Branch Office No 11,
Sreevalsam Building,
Alappzuha.
(By Adv.S.Devalal for opp: parties)
O R D E R
SMT. ELIZABETH GEORGE (PRESIDENT)
Complainant joined in the policy solely on the belief that the offered sum would be paid to her by the opposite party on maturity as described in the policy. As per the schedule appended to the policy, the date of commencement of the policy was 10/3/2007 and the date of maturity is 10/3/2017. That, the maturity sum assured under the policy was Rs. 1,25,000/- and the installment premium was Rs. 1531/- which had to be remitted in four quarterly installment every year, ie march, June September and December. The complainant is entitled in law to get Rs. 1,25,000/- towards maturity sum on paying Rs. 1531/- in the manner stated above, by way of premium. The complainant as per the terms and conditions of the policy remitted premium at the rate of Rs. 1531/- up to March 2016, without fail. While so as per letter dated 29/2/2016, which was received by the petitioner on 4/4/2016, it has been informed that there was an inadvertent typographical error in the maturity sum assured, which has been shown as Rs. 1,25,000/- and the correct maturity sum assured is Rs.44,990/- and called upon her to send original policy document to enable them endorse the policy document with the correct maturity sum assured. It was also informed that in case of failure to submit the original policy document for endorsement only Rs. 44,890/- would be payable to the complainant. On receipt of the said notice the petitioner sent a reply on 22/4/2016 in the 2nd opposite party seeking clarification as to why did he not informed the so called typographical error earlier and why he remained silent till the policy matured and when the time to make payment reached last and she has also informed that if it was informed earlier, she would have thought of discontinuing the policy. To the said reply, the 2nd opposite party issued a letter on 2/6/2016, stating that the maturity value would vary depending upon the age of the policy holder at the time of taking the policy and made some calculations to show that she is entitled only to Rs. 44,990/-. On the basis of the express representation that the complainant would be paid Rs. 1,25,000/- by way of maturity sum on the tenth year, the petitioner joined the policy and started paying the premium at the rate of Rs.1531/- each, in four installments per year. The policy conditions do not disclose anything regarding the variation of the maturity amount payable. Moreover, the opposite party have purposefully intimated the fact that only Rs. 44,990/- is payable as maturity sum in April 2016, just before the due date of maturity. As such the complainant is entitled in law to realize Rs. 1,25,000/- from the opposite party, as per the said policy. Alleging deficiency in service on the part of the opposite party the complaint is filed.
2. Version of the opposite parties is as follows:-
Complainant is the policy holder of the opposite party and name of the policy taken by the complainant is Jeevan Saral. In the policy certificate issued to the complainant due to an error in the computer printing the “Maturity Sum Assured” was not printed, the “Death Benefit Sum Assured” and the “Accident Benefit Sum Assured” were only printed. This mistake was an inadvertent omission remained in the policy certificate unnoticed. When this mistake was noticed by the opposite party it was duly intimated to the complainant through registered letter dated 20/02/2016 and the complainant was also requested to submit the policy certificate for making corrections in the policy. Admittedly the complainant received the said letter. But the complainant is still sticking on the stand that, she is entitled to get Rs. 1,25,000/- as maturity benefit which is the death benefit sum as per the terms of the policy. So the above complaint is one filed after knowing the true facts with the ulterior intention to exploit unjust enrichment out of inadvertent situation without any bonafides and is quiet experimental. Jeevan Saral policy is mainly the risk cover policy and contains higher financial protection against death throughout the terms of the plan. The proposer has to choose the amount of premium and mode of premium payment. The death benefit is directly related to the premium paid, i.e 250 times the monthly premium together with loyalty additions, if any and return of premium excluding first year premiums and extra/ rider premium. In the instant case the amount stated in the policy is the death benefit calculated at the time of issuance of the policy on the basis of the rate of monthly premium i.e. Rs. 500/- per month and the same is Rs. 1,25,000/- (500 x 250 = 1,25,000/-). The total gross maturity benefit is Rs. 60,961/-. The sum assured mentioned in the policy is actually the Death Sum Assured, and not the Maturity Sum Assured which was inadvertently omitted to be printed. This is evident from the fact that, the amount Rs. 1,25,000/- is printed twice because the “Death Sum Assured” and in the case of double accident benefit the Accident Sum Assured are same. The complainant is eligible for the Gross Maturity Benefit of Rs. 60,961/- only in conformity with rates applicable, subject to deduction of unpaid premium if any. Since the maturity benefit is not printed in the policy and is an uncertain sum at that time of issuance of the policy which is only calculated at the time of maturity of the policy, which depends on many factors like number of years, loyalty additions etc. The complainant who is an educated person who had opted the policy admittedly after having done due enquiry regarding all features of the particular policy is stopped form taking a plea that there is a contract agreeing to pay the maturity benefit at Rs. 1,25,000/-, which is the death benefit, solely depending on an omission in printing the maturity benefit in the policy.
3. Complainant was examined as PW1, documents produced were marked asExt.A1 to A9.Opposite party has no oral evidence the documents produced were marked as Ext.B1 and B2.
4. The points came up for considerations are:-
- Whether there is any deficiency in service on the part of the opposite party?
- If so the reliefs and costs?
- According the opposite party maturity sum assured was not printed in the policy certificate and only death benefit sum assured and accident benefit sum assured wereprinted and this mistake was an inadvertent omission remained in the policy certificate un noticed and when it was noticed they duly intimated it to the complainant.They further stated that the amount of Rs. 1,25,000/- is printed twice because death sum assured and in the case of double accident benefit, accident sum assured are same.Ext.A1 is the policy certificate.On verifying Ext.A1 it can be seen that for the 3 items specified on the top of column only 2 were noted under the column and one of the description was not printed. According to the Opposite party Maturity benefit is not printed in the policy and is an uncertain sum at the time of issuance of the policy which is only calculated at the time of maturity of the policy which depends on many factors like previous years loyalty additions etc.In Ext.A1 policy in condition No.1 it is stated that“ the maturity sum assured having been calculated on the age of the Life Assured as declared in the Proposal, in casethe age is found different from such age, without prejudice to the Corporation’s other rights and remedies, including those under the Insurance Act. 1938, the Sum Assured payable on maturity as shown in the Schedule will be correspondingly altered”.So it is clear that there was a typographical error happened on the part of the opposite party in printing the description in accordance with the entries on the top of the column. As per the policy the complainant is entitled to get Rs. 60,961/- as gross maturity benefit including loyalty additions subject to the payment of unpaid premium admitted by the complainant on maturity.From the above discussion we are of opinion that opposite party is liable to pay Rs. 60,961/- subject to the payment of unpaid premium by the complainant.
In the result complaint partly allowed.Opposite party is directed to pay Rs. 60,961/- as maturity sum assured if the complainant pays the unpaid premium.No further relief as to cost and compensation.Order shall be complied within one month on payment of un paid premium alone.
Dictated to the Confidential Assistant transcribed by her corrected by me and pronounced in open Forum on this the 19th day of March, 2018.
Sd/- Smt.Elizabeth George (President) :
Sd/- Sri. Antony Xavier (Member) :
Sd/- Smt.Jasmine.D. (Member) :
Appendix:-
Evidence of the complainant:-
PW1 - Lucy T.K (Witness)
Ext.A1 - Jeevan Saral Policy Certificate
Ext.A2 - Letter dtd. 29/2/2016
Ext.A3 - Renewal Premium Receipt dtd. 09/03/2016
Ext.A4 - Letter dtd 22/4/2016
Ext.A5 - Letter dtd. 2/6/2016
Ext.A6 - Letter 15/6/2016
Ext.A7 - Copy of Lawyer Notice dtd. 28/6/2016
Ext.A8 - Reply Notice dtd 25/7/2016
Ext.A9 - Intimation dtd. 15/12/2016.
Evidence of the opposite party:-
Ext.B1 - Certified copy of Jeevan Saral with Profit table
Ext.B2 - Maturity sum Assured Age and term
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite parties/S.F.
Typed by:- Br/-
Compared by:-
